October 10, 2013

OUR OPINION: Time to scrap state's plan for MaineCare rides

It's been a little more than two months since the state debuted a revamped system for getting low-income Mainers to medical appointments, contracting with two private companies to coordinate MaineCare rides.

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Sheena Patel, 27, has Down syndrome and relies on the MaineCare rides program for transportation from her South Portland home to a sheltered work environment in Portland, her father says. Coordinated Transportation Solutions – which coordinates MaineCare transportation in the Portland area and most of the rest of Maine – could lose its state contract for failing to provide adequate service.

2013 File Photo/John Ewing

And it's been almost exactly as long since complaints started flooding in from MaineCare patients about the system, including no-show rides, late rides and long hold times on the telephone to set up rides.

Now the state has put one of the ride service brokers on what amounts to probation. Coordinated Transportation Solutions, which serves all of Maine except York County and the Bangor area, could lose its $28.3 million contract if it doesn't address riders' concerns by Dec. 1.

It's questionable, though, whether giving the company two more months to improve will do anything but simply prolong a sorry situation. Instead, Department of Health and Human Services officials should work to revive the former locally based system and cut ties with CTS as soon as that network has been revived.

The state has offered mixed messages about the company's progress toward resolving rider complaints. DHHS Commissioner Mary Mayhew recently praised the company's September performance in an official memo, citing a decline in the number of missed trips.

A separate memo by another DHHS official, however, tells a different story. Putting CTS on notice that the future of its contract was in the balance, Stefanie Nadeau, the head of MaineCare services, wrote the company's president that patients still spend too long on hold and that up to 58 percent of all callers hang up in frustration before reaching a live person.

The DHHS has declined to state how many complaints the contractors have received and reported to the state. Nadeau's memo, however, does provide some hard data: It notes that CTS has received more than 3,300 complaints, not counting the unspecified number of concerns "received separately by the department."

Now Coordinated Transportation Solutions has until the beginning of December to straighten out its problems. Given what we know about the company's record so far, however, it's hard to envision a turnaround sufficient to meet the needs of all the Mainers who need dependable transportation to doctor's appointments, counseling, physical therapy and other medical services.

A much more viable alternative would be for the state to bring back the previous system, in which local nonprofits both arranged and provided rides. Indeed, ride providers based in Portland, Aroostook County and central Maine have said they could be ready to jump in within a mannger of weeks should the contract now in place be canceled.

Though patients liked the previous setup, the state, citing a federal mandate, scrapped the arrangement in favor of having regional brokers connect patients with the local providers. Vermont, however, has retained a locally controlled transportation system for its Medicaid recipients while still managing to meet federal criteria.

Coordinated Transportation Solutions' inability to fulfill the terms of its contract means that low-income residents statewide can't count on being able to access critically needed care. With local agencies prepared to step up -- and another New England state presenting an example of a functioning, federally compliant ride system -- there's no reason for Maine to continue with a system that's not working.

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